West meets East for better health care

09/16/2013

Five honors students from The University of Akron's School of Nursing visited two hospitals in Kaifeng, Henan, China, last summer to study patients' use of Traditional Chinese Medicine (TCM) and observe communication styles between patients and health care providers. They will present their findings on Wednesday, Oct. 9, at 12:05 p.m. in the Honors Common Room as part of UA's annual "China Week," sponsored by the Confucius Institute.

The research project — the result of collaborative efforts between UA and Henan University, UA's partner through the Confucius Institute — is intended to improve understanding of TCM, foster communication between patients and physicians, and prevent potentially dangerous interactions between Traditional Chinese Medicine and Western medicine, says Sheau-Huey Chiu, an assistant professor of nursing who was the faculty member guiding the students' experience.

The nursing students — Becky Ciocca, Kate Cottrill, Michael Lionetti, Brittany Sanford and Brittany Hirth — went to Henan University in Kaifeng, a city in the Henan province of China, and partnered with Henan University nursing students to interview patients in two local hospitals about their use of TCM and their communication with health care providers.

The students report that the patients they interviewed were more open with providers about their use of TCM than are patients in the United States.

Chiu says that although TCM is increasingly being used in the United States, often in conjunction with Western practices, "many studies have shown a lack of communication between patients and their health care providers about the use of TCM or complementary therapies."

Lack of communication poses risks

Chiu adds that patients, fearing disapproval, are often reluctant to tell their health care providers about their use of complementary medicines, and that this reluctance can pose health risks.

Sheau-Huey Chiu

"This lack of communication could potentially place the patients' health in jeopardy due to potential interaction between TCM and Western medicine if the patients' health care providers are not aware of the use of TCM," Chiu says. "Herbal medicine may have other effects that patients are not aware of and could be contraindicated in patients with certain illnesses."

The students found that TCM was regularly prescribed and administered in the hospitals they visited, often alongside Western therapies.

"There was a whole hospital dedicated to traditional medicine," Ciocca says. "There was acupuncture in every hospital we went to. We went to a rehab facility where they had Western physical therapy equipment, but in the same area there was a room where they were doing acupuncture and moxibustion [the therapeutic use of moxa, the mugwort plant, which is burned and placed near the skin, often during acupuncture] and another room for herbal therapy — we walked in there and, I mean, the smell was overwhelming."

Cottrill adds that Western and traditional medicine are not at odds in China, but rather complement each other.

Unique system benefits patients

"Obviously they have implemented Western medicine in their practice, but at the same time it's combined with traditional medicine," she says. "They're not saying one or the other is better; they're just combining them to make a better health care system."

Cottrill says she would like to see this combined approach replicated in the U.S., but "a lot of the research on the effectiveness of TCM is inconclusive.

"I would like to see better clinical trials, because a lot of the research I viewed was incomplete," she says. "In America, people are spending so much out-of-pocket just for traditional medicines. But if we proved that it worked, and could somehow implement it into our lives, then insurances could cover it, and more people could have access to it."

It would be safer, too, Cottrill adds. She explains that improved communication between patients and providers and herbal medicine regulation could prevent adverse interactions between traditional and Western practices.

Kathleen Ross-Alaolmolki

"Over there, the herbal medicine is carefully prescribed and highly regulated, but here in the U.S. it's not regulated, and people purchase it over the counter without knowing what's in it or how it'll affect them," Cottrill says.

Confucius Institute enhances understanding

The project was made possible by UA's partnership with Henan University through the Confucius Institute. Supported by the Chinese Ministry of Education and part of an international network, the Confucius Institute is dedicated to enhancing the understanding of Chinese language and culture.

Kathleen Ross-Alaolmolki, professor of nursing and associate dean of academics in the College of Health Professions, says she went to Henan with Chiu two years ago to plan the research project and lay the groundwork for an ongoing student and faculty exchange program with Henan.

Ross-Alaomolki says preparing future nurses for the challenges of an increasingly complex and global health care system demonstrates the importance of UA's Confucius Institute partnerships.

"Today's professional nursing students are learning to navigate in an increasingly complex system where they encounter people from many different cultures within the United States," she says. "This experience with Chinese culture and the Chinese health care system provided an opportunity to honors nursing students to gain a genuinely eye-opening perspective, though brief, on communication between health care providers and patients in one area of China."

Holly Harris Bane

Global view benefits students

Holly Harris Bane, associate vice president for strategic initiatives and partnerships, adds that the Confucius Institute — which paid for the students' airfare — aims to prepare students to be competitive in the global marketplace. (Additional support was provided by the Honors College and Sigma Theta Tau, Delta Omega Chapter of the International Honor Society of Nursing.)

"China is the fastest-growing economy in the world," says Harris Bane. "Companies are looking for students who can speak Chinese and work in China. But even if you don't plan to work overseas, even if you plan never to leave Ohio, the classroom of today, the medical room of today, the hospital bed of today — they're more diverse than ever. With any kind of global experience, you’ve got a competitive edge."

The Confucius Institute's annual "China Week," in which students, faculty and the public are invited to attend a variety of lectures, presentations and activities exploring diverse aspects of Chinese culture, will be held Oct. 6-11.